Journal of agricultural medicine and community health
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v.35
no.4
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pp.350-360
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2010
Objectives: This study was conducted to identify factors that affect medical service performance in rural health sub-centers and to develop a method to improve health sub-center performance that takes advantage of these insights. Methods: This study included 1,242 South Korean health sub-centers that had been in operation at least since December 31, 2009 as units of analysis. After adjusting for population differences between areas, the performance of medical service among health sub-centers was analyzed according to medical services performed per person. We performed t-tests, ANOVA, Scheffe's tests and multiple regression analyses. Results: The following were significant variables affecting the medical service performance of rural health sub-centers: number of hospitals and clinics, presence of community health practitioner posts, distance from health sub-centers to main public health centers, distance from health sub-centers to the nearest emergency medical facilities, and proportion of the local population aged 65 and over. In contrast, the proportion of the local population between ages 0-4 and the placement of public health doctors that had already completed their internship were not significant variables. Conclusions: The medical service performance of health sub-centers located in rural areas is significantly affected by local population and health care environment characteristics, and therefore, it is imperative to develop strategies to provide differentiated service based on these factors.
Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.
The purpose of this study was to investigate the residents' opinions about community mental health in the Taegu-Kyungpuk area for the future development of a community mental health program and model appropriate for Korea, The subjects were 152 residents in the Taegu - Kyungpuk area. In July 1999, the data was collected using a convenience sample technique. Mental health status was significantly different for the level of occupational advantage(x$^2$=15.684, p<.05) and physical health(x$^2$=39.262, p<.000). Factor structure for mental health problems with the percentage of variance was as follows. optimistic view(27.518), dark view(10.758), mastery(6.200), discomfiture(6.101) and life style(5.641). Most of the respondents(92.1%) took the mental health problems seriously. The serious aspects of the mental health problem were found to be epilepsy, mental retardation, neurosis and schizophrenia respectively. Concerning about the view of community mental health, most of the respondents answered that the a C.M.H.C. was ‘useful and urgent’ concerning the need for C.M.H,(77.6%). They answered positively on the utilization of C.M.H.C(75.7% ) and preferred the separately new community mental heath center. A psychiatrist was preferred as the key person in charge(44.1%). If community mental health centers were established in a community health center, they answered that the expected major problem would be quality control of care(44.7%). They preferred the psychiatrist's office as the recommended agency for the insane(44.7%). Opinions of the asylum system were found very negative in respect to psychiatric therapy and humanitarianism. The results of this study will help establish a relevant model for this community as the primary site for a community-based mental health model.
Purpose: This study sought to provide basic information for the establishment of home care nursing system in cancer patients. Methods: Data were collected by the descriptive questionnaires consisting of 42 articles from five fields of nursing services. Patient's symptoms were investigated by the Korean version of EORTC QLQ-C30. Data were analysed using SPSS-PC 12.0. Results: Among the cancer patients (n=182), 40.1% had serious limitations on their usual lives. 74.7% had serious economic burdens. 79.7% agreed strongly with the necessity of home care nursing system, 74.2% were willing to use home care nursing, and 91.2% felt that home care nursing should be mandatory in cancer centers. There was no correlation between the frequency of symptoms or nursing items and the degree of home care nursing requirements. Digestive symptoms, symptoms requiring procedures, and symptoms to meet educational help displayed a high degree of requirement. Conclusion: Home care nursing should be activated for cancer patients as a bridge between hospital-based acute care and community-based chronic care which could increase the quality of care and reduce insurance related payments.
This study was conducted to, develop the social workers role participating health and welfare services production of health centers The sharp increase rate on the elderly population in Korea lead the social issues as that health and social services are not developed enough to cope with the increase on the elderly's hearth care needs. The priority in the elderly's care service development should be put on public sectors. so that could prevent financial catastrophy of the elderly's care. The pulbic sector was concerned with health center services : as health center in Korea provide :mainly medical-oriented services. this study focused on to combine the existing health center's services into social services. The study method was based on needs survey with 322 patients aged over than 55 in rural area. "The needs survey include general health and disease care needs and daily life caring needs. The latter was applied with ADL and IADL with modificiation for the use of Korea environment. The findings were as follows : Social workers should be able to care diseases of muscular and skeletal. circulatory, digestive and general chronic disease in social service needs. aspect. Mostly the chronic pateints quit their care services because of shortage of finanical support$(18.3\%)$ and transportation problem$(19.5\%)$, but still prefer to be cured and cared from general hospitals. and at least clinic and health centers in community. The univisible dramatic effect. of health. care services also should be concerned and cared by xocial workers. The ADL and! IADL shown the most needs on transportation needs and problems caused by weaken legs. Mostly daily activities were supported by family members $(53.3\%\;spousers\;and\;35.0\%\;children)$, and the most demands were shown on helps for transportation visiting hospitals$(37\%)$ and getting similar care services for health care needs $(31.2\%)$ and daily hygeieal needs$(11.2\%)$ Social workers' role should include health care participation with social and health promotion approach as well as socio-economic supports: during health care receiving. Social workers also should provide social services for the elderly's daily needs solving for these are not in available family supporters.
Background: The purpose of this study was to evaluate the effectiveness and the level of self-management support on the Metabolic Syndrome Management Program at public health centers in Seoul metropolitan city. Methods: The effectiveness on the Metabolic Syndrome Management Program were analyzed using secondary data from 1,312 community residents who were receiving program. The level of self-management support on Metabolic Syndrome Management Program was evaluated using an 'Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management' from four public health centers. Results: The effectiveness on the Metabolic Syndrome Management Program was showed that decreased smoking (p= 0.044) and drinking (p< 0.001), and increased healthy dietary habit (p< 0.001) in health behaviors. It was showed that decreased triglyceride (p= 0.002) and increased high-density lipoprotein cholesterol (p< 0.001) in clinical indicators. The level of self-management support on Metabolic Syndrome Management Program was 98.1 points and it meaned that implementation is done in an organized and consistent manner using a team approach. There was difference in the level of self-management support by public health centers (p= 0.003). Conclusion: The Metabolic Syndrome Management Program in public health centers was effective, and level of self-management support was done as organizational level, but patient input and mental health were insufficient.
This study attempts to identify attitudes of community leaders toward mental illness in order to obtain useful information concerning the planning of community mental health services. The community sample consists of 50 community leaders including, civil servants, doctors, herb doctors, school nurses, counselors, village leaders, pharmacists, and pastors. Individuals were asked to give demographic data, their personal attitudes toward mental illness' etiology & prognosis, and toward neighbors who are psychiatric patients. The interview with open questions was used to collect data. According to the study community leaders 82% believed that mental illness could be treated, 66% believed that mental illness was caused by genetic factors and environmental stress, and 76% had negative impressions about mentally ill people such as fear, seclusion, asylum, also crime. Only 28% of mentally ill people were accepted as neighbors in community. 52% of community leaders rejected opening of mental hospital, and thought that the Chunchon community needed facilities such as group homes, or day care centers (30%), however, 34% of the leaders they didn't recognize community mental health. These findings suggest that mental health professionals need to pay special attention to change the attitude of Chunchon community leaders and mental health institutions need to a develop mental health education program for community leaders.
Background: Breast cancer is the most common cancer in women. All ages are susceptible and more than 90% of the patients can be cured with early diagnosis. Breast self-examination (BSE) and mammography can be useful for this aim. In this study we examined the components of the Champion health belief model to identify if they could predict the intentions of women to perform such screening. Materials and Methods: A total of 380 women aged 30 and above who had referred to health-care centers were assessed for use of breast cancer screening over the past year with a modified health belief model questionnaire. Logistic regression was applied to identify leading independent predictors. Results: In this study 27% of the women performed BSE in the last year but only 6.8% of them used mammography as a way of screening. There were significant differences regarding all components of the model except for perceived severity between women that underwent BSE. over the past year and those that did not. Findings were similar for mammography. Regression analysis revealed that intentions to perform BSE were predicted by perceived self-efficacy and perceived barriers to BSE while intentions to perform mammography were predicted by perceived barriers. Conclusions: This study indicated that self-efficacy can support performance of BSE while perceived barriers are important for not performing both BSE and mammography. Thus we must educate women to increase their self-efficacy and decrease their perceived barriers.
This study was carried out to examine the effects of nutrition education program developed by Jincheon Public Health Center on preschool children's nutrition knowledge and dietary habits and the parents' dietary attitudes. The subjects of this study were five- and six-year-old children as well as their parents. A 5-week nutrition education program was implemented to 104 children in five day care centers, and 107 children in three day care centers were investigated as a control group. Activity tools designed for each lesson such as puzzles, food magnets, story, songs, Pierrot costume, and balls were used. Nutrition knowledge and dietary habits of children and dietary attitudes of parents were evaluated before and after education. Mean nutrition knowledge score in the education group was significantly higher than that in the control group after education (p < 0.001). Mean dietary habit score of three questions (three meals a day, eating at fixed time, eating breakfast) in the education group was also significantly higher than that in the control group after education (p < 0.01). In addition, parents in the education group showed significantly higher mean dietary attitude score than those in the control group even though they did not receive education (p < 0.001). Our nutrition education program was found to be effective in improving nutrition knowledge and dietary habits in preschool children as well as improving dietary attitudes in their parents.
Kim, Yong-Soon;Park, Jee-Won;Bang, Kyung-Sook;Jung, Soon-Re;Woo, Hea-Suk;Lee, Hea-Jung;Jang, Hyeon-Soon
Research in Community and Public Health Nursing
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v.13
no.2
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pp.280-291
/
2002
Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.
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